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Frailty trajectories in three longitudinal studies of aging: Is the level or the rate of change more predictive of mortality?
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
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2021 (Engelska)Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 50, nr 6, s. 2174-2182Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality. Objectives: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality. Methods: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis. Results: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age similar to 75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement. Conclusions: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2021. Vol. 50, nr 6, s. 2174-2182
Nyckelord [en]
frailty, trajectories, mortality, age at death, older people
Nationell ämneskategori
Gerontologi, medicinsk/hälsovetenskaplig inriktning
Identifikatorer
URN: urn:nbn:se:hj:diva-55724DOI: 10.1093/ageing/afab106ISI: 000743035600059PubMedID: 34120182Scopus ID: 2-s2.0-85120159344Lokalt ID: HOA;;793139OAI: oai:DiVA.org:hj-55724DiVA, id: diva2:1632598
Forskningsfinansiär
NIH (National Institute of Health), R01 AG04563, AG10175, AG028555, AG08861-09Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 97:0147:1B to N.L.P., 2009-0795 to N.L.P.Vetenskapsrådet, 825-2007-7460, 825-2009-6141, 521-2013-8689, 2015-03255, 2018-02077 to J.J., 2016-03081, 2019-01272 to S.H.Magnus Bergvalls StiftelseKonung Gustaf V:s och Drottning Victorias FrimurarestiftelseTillgänglig från: 2022-01-27 Skapad: 2022-01-27 Senast uppdaterad: 2022-10-31Bibliografiskt granskad

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Av författaren/redaktören
Karlsson, Ida K.Jylhava, Juulia
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HHJ, Institutet för gerontologiHHJ. ARN-J (Aging Research Network - Jönköping)
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Age and Ageing
Gerontologi, medicinsk/hälsovetenskaplig inriktning

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